When a death occurs in professional sport context or in any apparently healthy young individual, public opinion demands an adequate response from the clinical and scientific community.
Few medical conditions are more traumatic than sudden cardiac death (SCD), not anticipated by any symptom, of a young person. It is a rare event, generally linked to a fatal arrhythmia, but its dramatic presentation and the impact on the family and the whole community finds an amplified resonance in the cases of athletes, perfectly exemplifying the metaphor of a vulnerability hidden in an apparently healthy body.
In the general population, there is great concern about juvenile SCD risk, a perception even greater than that experienced in more frequent fatal conditions, such as accidents, suicides, violence. Overall, it is justified to consider the SCD of the young as a threat to global health. The development of strategies based on both scientific evidences and expert consensus is therefore required to reduce the impact of juvenile SCD.
SCD in young people, including about 25% of cases occurring during sports activities, is rare (estimated incidence is between 1 and 10 cases/100000 people/year), but its impact in terms of years of life lost is considerable, given the long life expectancy of young people. Cardiac arrest in a young person can be caused by hereditary conditions, such as hypertrophic, dilated and arrhythmogenic cardiomyopathies, or mutations that alter the proteins that control the heart rhythm causing diseases in which the patient’s heart, while appearing normal to clinical investigations, is predisposed to have serious arrhythmias (the so-called channelopathies: long QT syndrome and short QT, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia). In the individual patient, these conditions can be asymptomatic and undiagnosed, so that sudden cardiac death may be the first clinical manifestation. It is estimated that cardiopulmonary resuscitation and the widespread availability of external semi-automatic defibrillators could prevent about a quarter of juvenile SCD.
The topic of SCD in the young will be addressed by experts evaluating pathophysiologic, diagnostic and therapeutic issues related to this fatal condition. Thanks to the Fondazione Menarini, we will have the opportunity to meet in Pisa, one of the most beautiful cities in Tuscany, in a workshop endorsed by all the University and Research organizations of the city, currently involved in a research project on juvenile SCD. We hope that participating to this workshop will be as interesting and stimulating as its organization.